No consensus exists regarding the role of radiotherapy in the management of gynecologic cancer in nonagenarian patients.We retrospectively reviewed the outcomes of 19 consecutive nonagenarian patients with gynecologic...No consensus exists regarding the role of radiotherapy in the management of gynecologic cancer in nonagenarian patients.We retrospectively reviewed the outcomes of 19 consecutive nonagenarian patients with gynecologic cancer(6 endometrial cancers,6 cervical cancers,4 vulvar cancers,and 3 vaginal cancers) who were treated with radiotherapy.Radiotherapy was performed mainly in a palliative setting(n = 12;63.2%),with a median dose of 45 Gy(range,6-76 Gy).Infrequent major acute or late toxicities were reported.Among 19 patients,9(47.4%) experienced tumor progression,5(26.3%) experienced complete response,2(10.5%) experienced stable disease and/or partial response.At last follow-up,12 patients(63.2%) had died;most deaths(n = 9) occurred because of the cancer.These results suggest that radiotherapy is feasible in the treatment of nonagenarian patients with gynecologic cancer.展开更多
AIM:To assess the feasibility of volumetric intensity-modulated arc radiotherapy (VMAT) in patients with limited polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes syndrome. METHODS:...AIM:To assess the feasibility of volumetric intensity-modulated arc radiotherapy (VMAT) in patients with limited polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes syndrome. METHODS:A 70-year-old male with histologically confirmed osteosclerotic myeloma was treated in our department in July 2010 with VMAT. Fourty-six Gray in 23 fractions were given on three bone lesions. Doses delivered to target volume and critical organs were compared with a tridimensional conformal radiotherapy (3D-RT) plan. Treatment was well tolerated without any side effects.RESULTS:VMAT improved dose homogeneity within the target volume, as compared to 3D-RT (standard deviations:2.9 Gy and 1.6 Gy for 3D and VMAT, respectively). VMAT resulted in a better sparing of critical organs. Dose delivered to 20% of organ volume (D20) was reduced from 22 Gy (3D-RT) to 15 Gy (VMAT) for small bowel, from 24 Gy (3D-RT) to 17 Gy (VMAT) for bladder and from 47 Gy (3D-RT) to 3 Gy (VMAT) for spinal cord. Volumes of critical organs that received at least 20 Gy (V20) were decreased by the use of VMAT, as compared to 3D-RT (V20 bladder:10% vs 99%; V20 small bowel:6% vs 21%). One year after treatment completion, no tumor progression has been reported. CONCLUSION:VMAT improved dose distribution as compared to 3D-RT for limited osteosclerotic myeloma, with better saving of critical organs.展开更多
文摘No consensus exists regarding the role of radiotherapy in the management of gynecologic cancer in nonagenarian patients.We retrospectively reviewed the outcomes of 19 consecutive nonagenarian patients with gynecologic cancer(6 endometrial cancers,6 cervical cancers,4 vulvar cancers,and 3 vaginal cancers) who were treated with radiotherapy.Radiotherapy was performed mainly in a palliative setting(n = 12;63.2%),with a median dose of 45 Gy(range,6-76 Gy).Infrequent major acute or late toxicities were reported.Among 19 patients,9(47.4%) experienced tumor progression,5(26.3%) experienced complete response,2(10.5%) experienced stable disease and/or partial response.At last follow-up,12 patients(63.2%) had died;most deaths(n = 9) occurred because of the cancer.These results suggest that radiotherapy is feasible in the treatment of nonagenarian patients with gynecologic cancer.
文摘AIM:To assess the feasibility of volumetric intensity-modulated arc radiotherapy (VMAT) in patients with limited polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes syndrome. METHODS:A 70-year-old male with histologically confirmed osteosclerotic myeloma was treated in our department in July 2010 with VMAT. Fourty-six Gray in 23 fractions were given on three bone lesions. Doses delivered to target volume and critical organs were compared with a tridimensional conformal radiotherapy (3D-RT) plan. Treatment was well tolerated without any side effects.RESULTS:VMAT improved dose homogeneity within the target volume, as compared to 3D-RT (standard deviations:2.9 Gy and 1.6 Gy for 3D and VMAT, respectively). VMAT resulted in a better sparing of critical organs. Dose delivered to 20% of organ volume (D20) was reduced from 22 Gy (3D-RT) to 15 Gy (VMAT) for small bowel, from 24 Gy (3D-RT) to 17 Gy (VMAT) for bladder and from 47 Gy (3D-RT) to 3 Gy (VMAT) for spinal cord. Volumes of critical organs that received at least 20 Gy (V20) were decreased by the use of VMAT, as compared to 3D-RT (V20 bladder:10% vs 99%; V20 small bowel:6% vs 21%). One year after treatment completion, no tumor progression has been reported. CONCLUSION:VMAT improved dose distribution as compared to 3D-RT for limited osteosclerotic myeloma, with better saving of critical organs.
